PrEP in California — pre-exposure prophylaxis, who qualifies, how to start

Pre-exposure prophylaxis (PrEP) is a daily pill (Truvada, Descovy) or every-two-months injection (Apretude) that prevents HIV in people who don't have HIV. Taken as prescribed, daily-pill PrEP reduces the risk of sexually transmitted HIV by about 99% and the risk from injection-drug sharing by about 74%, per CDC. In California, PrEP is available through primary-care providers, FQHCs, LGBTQ+ community health centers, and Ryan White Part C clinics — you do not need to see an HIV specialist to start.

To qualify for PrEP you need a recent negative HIV test (or one done the same day), a baseline labs panel (kidney function, hepatitis B, STIs), and a prescriber visit. Follow-up is every three months for a repeat HIV test and medication refill. Most insurance including Medicaid covers PrEP with zero out-of-pocket under the USPSTF Grade A preventive-services rule. The drug manufacturers (Gilead, ViiV) operate patient-assistance programs for anyone without insurance.

California operates PrEP Assistance Program (PrEP-AP), layered on top of the federal Ready, Set, PrEP program. Eligibility in California goes up to 500% of the federal poverty line, which covers clinician visits, lab work, and medication. Apply through the state HIV program line at 1-800-367-2437 or any community HIV organization that holds a state PrEP navigation contract.

Black PrEP uptake nationally lags sharply — a 2023 AIDSVu analysis found that Black Americans account for 42% of new HIV diagnoses but only 14% of PrEP users. Long-time Black residents name APLA Health and San Francisco AIDS Foundation (SFAF) — Strut as the local institutions that show up consistently — both are listed below.

APLA Health. APLA Health (formerly AIDS Project Los Angeles) operates seven FQHC sites across Los Angeles County and is the largest Ryan White provider in California, with dedicated Black health-equity programming through its Black Treatment Advocates Network.

San Francisco AIDS Foundation (SFAF) — Strut. SFAF's Strut clinic in the Castro runs one of the nation's highest-volume PrEP programs; SFAF also operates the Black Brothers Esteem program, the Bay Area's Black-men-centered peer support and HIV prevention initiative founded in 1991.